In the majority of cases when an individual is ill, they are able to talk to their doctor and mutually reach a decision about their treatment. It is a vital point of law that a mentally competent adult has to consent to medical treatment; it cannot be forced upon them.
However, there are times where an individual maybe unable to communicate their wishes to their doctor or a medical team. For example, if they are unconscious or have lost the mental capacity to be able to agree or disagree to any medical treatment.
In these circumstances, a statement of that individual’s wishes with regard to medical treatment is extremely important and is known as an ‘Advance Medical Directive’ (AMD) or a ‘Living Will’.
An AMD is a decision you can make now to refuse a specific type of treatment at some time in the future. It lets your family, carers and health professionals know your wishes about refusing treatment if you’re unable to make or communicate those decisions yourself. You specify the circumstances in which you want to refuse this treatment.
Deciding to refuse a treatment isn’t the same as asking someone to end your life or help you end your life (euthanasia or assisted suicide), both of which are illegal in England.
Life-sustaining treatment – You can refuse a treatment that could potentially keep you alive, known as life-sustaining treatment, which is treatment that replaces or supports ailing bodily functions. If you decide to refuse life-sustaining treatment in the future, your advance decision needs to be in writing, signed by you and signed by a witness.
If you wish to refuse life-sustaining treatments in circumstances where you might die as a result, you need to state this clearly in your AMD. Life-sustaining treatment is sometimes called life-saving treatment.
An AMD is legally binding as long as it complies with the Mental Capacity Act, is valid and applies to the situation
If your advance decision is binding, it takes precedence over decisions made in your best interest by other people.
As long as it’s valid and applies to your situation, an advance decision gives your health and social care team clinical and legal instructions about your treatment choices. An advance decision will only be used if, at some time in the future, you’re not able to make your own decisions about your treatment.
You have the final say on who sees your AMD, but you should make sure that your family, carers or health and social care professionals know about it, and know where to find it. Your family or carers may have to find it quickly if you require emergency treatment and they need to tell the healthcare professionals your wishes. For this reason you should keep a copy in your medical records.
Making an AMD is one of the last kindnesses you can bestow upon your children – the absolute knowledge that this is what you would have wanted.